ATI MEDSURG UPDATED 2024

ATI MEDSURG UPDATED 2024

hypokalemia ECG reading low potassium = Flat T waves

hypercalcemia deep tendon reflexes too much calcium = Decreased deep tendon reflexes

hyperkalemia too much potassium = tall peaked T waves

Hypocalcemia low calcium = tetany

addisons disease decreased aldosterone & renin cushings disease elevated cortisol hypothyroidism decreased T3 & T4

Diabetes insipidus decreased urine specific gravity

Syndrome of inapproprate secreation of antidiuretic hormone increased urine osmolarity

diabetes mellitus elevated HbA1c - glycosyated hemoglobin

cataracts progressive , painless loss of vission Retina detachment sudden loss of vision open angle glaucoma loss of peripheral

Stable angina occurs with exercise, stress but relieved by nitro

variant angina due to coronary artery spasm, during periods of rest Unstable angina occurs with exercise, stress but increases in severity over time maclar degeneration central loss of vision

angle closure glaucoma increased IOP

appendicitis assessment pain at mcburneys point - diagonal from appendices to navel

PUD assessment upper eppigastric pain 1-2 hours after eating.

Cholecystitis assessment pain at murphy sign = upper right under rib .

Pancreatitis assessment turners sign = bruising decorticate rigidity upper extremities flexed , lower rigid decerebrate upper extermeties extended away from cerebrum

Hep A transmission ingestion of contaminated food / water - MEXICO

Hep B transmission Sex Nonviral Hep Drug toxicity CHF S&S sob, fatigue, DVT, S3

hypovolemic shock position supine with legs elevated

continuous bubbling in chest tube water seal chamber indicated there is a leak. find leak, tighten the connections or replace drainage system

Stage 3 HIV symptomes -Disseminated or extrapulomonary histoplasmosis .

-kaposi sarcoma.

-burkitts lymphoma .

cardiac injury labs Myoglobin - 24hr marker. troponin - 7day window.

PH   7.45 - 7.35

PCO2 35 - 45

HCo3 22 - 28

Pericarditis abnormal finding Report paradoxical pulse

Seizure Seizure are abrupt excessive and uncontrolled electrical discharge of neurons within the brain that can cause LOC, or changes in motor / sensory ability and behavior. Dx: EEG for region

Interventions = move client to floor, patent airway, suction, turn to side, loosen clothing, document, check vitals, neuro check, reorient.

Treatment = AEDs like phenytoin(lessen effects of warfarin & contraceptives)

Problems = status epilepticus lasting 30+ mins. Airway, oxygen, IV, ECG, O2 sat, ABG, give loading dose diazepam & IV phenytoin.

Parkinsons Parkinsons is a progressive desease affecting motor function due to over stimulation of basal ganglia by acetocoline.

Dx: s&S

Interventions : meds, monitor swallowing and nutrition, mobility, communication, mental and cog status.

Treatment: Increase dopamine or decrease acetocoline. take several weeks. Dopamine agonists - monitor orthostatic hypotension, dyskenesias, hallucinations.

Anticcholinergics - monitor dry mouth, constipation, ur.

Alzheimers nonreversable dementia charactorized by memory loss, judgment problems, and changes in personality.

Dx: apolipoprotien

Interventions : asses S&S, sleep/bowel/bladder program, family support group, snacks & fingerfoods, verbal/nonverbal communication options, memory training, avoid overstim, promote consistancy and reorient, speak direct in short concise sentences.

Treatment: prevent acetylcholine breakdown (ACH) with donepezil, estrogen, ginko.

Multpiple sclerosis MS is an autommune disorder charactoerized by plaque in the white matter of CNS. alyloid plaque damages myelin sheath and interferes with impuse transmission.

Dx: MRI shows plaque, CSF shows elevated protien & WBC.

Intervnetions: monitor swallowing, vision, activity, skin, speech, coping, encourage fluid to prevent UTIs, bladder/bowel program, communication board, eye patch for diplopia, exercise, grouping ADLS.

Treatment: Immunosuppressants & antispasmodics. prednisone= monitor infection, DM, hypok, gi bleeding. Dantrolene= antispasmotic liver and muscle weakness. anticholinergics = bladder dys.

ICP interventions ICP intervnetions:

elevate head of bed 30 degrees. maintain patent airway. O2 sat 92% and higher.

keep PaCO@ 35-38 mm Hg.maintain cervical spine stability until cleared by xray. seizure precautions. manitol and monitor osmolality q6 hrs.

Stroke CVA involve disruption in cerebral blood flow due to ischemia, hemorrahge or embolism.

Dx: MRI, CT, CAT scans.

Interventions: vitals q1-2hrs report b/p over 180.

monitor temp, maintain co2 92% +, cardiac monitor, LOC, ICP, elevate head of bed 30 degrees, seizure precautions, assist with ADLS, feeding, mobility.

TX: low dose aspirin 24-48hrs after stroke, retavase within 4.5 hrs.